Individual
CAROL ELLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
901 N MAIN AVE, BRIDGEWATER, SD 57319-2004
(605) 421-8549
Mailing address
804 MULBERRY ST, YANKTON, SD 57078-3623
(605) 660-6497
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
0078
SD
Other
Enumeration date
02/05/2019
Last updated
02/05/2019
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